Reimbursement and Pay-for-Performance free essay sample

There could be an impact of the health care quality and efficiency by providers getting financial rewards if they show better care for patients as well as showing quality of performance. P4P could affect the providers and customers by the measured performance, payment policy, and the involvement implementation matters. The P4P effects that will be seen in the future of health care is that the population will see that pay-for-performance will expand, especially the Affordable Care Act. Pay-for-Performance-defined A reimbursement plan that links payment to quality and efficiency as an incentive to improve the quality of health care and to reduce costs† (Shi amp; Singh, 2012). Pay-for-performance is being turned to by payers and those who make policies. The P4P initiatives objective is to reimbursement to excellence and effectiveness to increase health care quality and to decrease costs. Agencies of the government are starting programs for providers to be encouraged to encounter e xcellent values. We will write a custom essay sample on Reimbursement and Pay-for-Performance or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page When there is improvement in care and effective performance by providers, the providers may see financial rewards. It was expected that hospitals would respond to P4P incentives, but there is little evidence that this has happened. The Affect of Pay-for-Performance on Reimbursements The objective of the pay-for-performance is to improve the quality of care from incentives for providers to be awarded by showing better performance and better quality of care. P4P changes the monetary incentives that sway providers. It should reflect the current incentives that would strengthen or put off the services that are delivered. Some health care treatments and procedures compensated more liberally than other services. P4P can be said as a program to make right some incentives that are misrepresented that many occur in the reimbursement delivery. Some pay-for-performance programs are trying to reassure readjustment of providers’ priorities to prevention. There are some tests, such as screening, that have been under reimbursed to providers. This can have an emotion impact the quality of care, but there is much to learn by the payers on how to get the quality of care effectively. The payers face some challenges. They have to deal with patients who are severely ill or patient’s behaviors, and still give high-quality care. Pay-for-performance could take away some distortions that come about by the primary arrangement of the existing imbursement structure. This could assist in changing health care delivery on the serious aspects of the residents’ health. Health Care System Cost Reductions Impacts the Quality and Efficiency Cost reduction could impact the quality and efficiency of health care by using information technology (IT). It was a federal policy initiative to increase the outcome of patient’s health (Jacobs, 2012). It was for hospitals to increase the use of technology to assist to manage expenses. It ended up improving the patient’s quality of care. It also changed Medicare way of how providers were to be reimbursed. Pay-for-performance was an approach to give providers incentives to bring about a quality of performance and to increase quality of care plus reducing costs. Providers that give the economical care yet meeting the greatest specific standards, will get the biggest reimbursement (Santo, 2013). An impact also is that many providers are being near ability in their capacity to offer better care. When there is a list of subjective measures that needs to be followed for providers to be reimbursed, this only confuses and aggravates the providers. Also when providers see their reimbursement is being cut, this makes them to stop serving the severely ill patients. By stop seeing some patients, this gives them time to up the quality of care and â€Å"lower the cost at the same time† (Santo, 2013). With CMS deeming the way reimbursement is being done, many providers will refuse to take on new Medicare patients. This will have a big impact on many older adults who may have to change providers for some reason or another. As pay-for-performance is becoming more involved in health care, providers will see a drop in reimbursements. One way for hospitals to show remarkable cost savings is to format guidelines for common use without losing quality of care (VHA, 2013). P4P Affects Health Care Providers and Customers Even though P4P is to give providers incentives to give quality care and lower costs, it is still in the early stages and cannot decide whether P4P is going to be effective in lowering health care costs. Currently, providers are paid for what services they perform, even if the services were not necessary. This does not reduce costs. With P4P, providers are encouraged to minimize procedures and treatments when possible (Montgomery, 2007). With the ObamaCare, physicians and their employees responsible financially for changes that are mandatory, defined by CMS. This affects the providers by the complexity of all the changes that has to be adopted into their present practice. This can be an overwhelming task for the providers. The current responsibilities takes up much of the providers time and energy and takes them further from just treating patients, working to cure diseases, and making an actual difference in the health issues of others. Some thinks that pay-for-performance is a rearranging of the status quo (existing state or condition) and should benefit the providers’ profession and the long-term patients. With P4P being in the early stage, it cannot be predicted how P4P will impact the provided quality of care or the costs. The customers are affected by many providers refusing to accept patients who are new to Medicare. P4P is more apprehensive with how providers get paid for their services, but there probably will not be a great impact on some patients (Montgomery, 2007). It is hoped that P4P will let patients appreciate improved health care at no costs when P4P is entirely implemented. Effects on Pay-for-Performance Will Have Future Health Care In the future, pay-for-performance will probably expand through the United States with its health care. It will be more probable if ObamaCare’s Affordable Care Act is implemented. The future of P4P has many questions to be answered especially in initiatives, such as: * How large should the rewards be? * How will distributed of rewards be considered too often? * How will performance be improved? Evaluation of the P4P should account for the different distinctions in marketing of health care, such as quantity of physicians and other providers (Health Affairs, 2012). In the future, P4P programs will propose a wider variety of policy structure to announce the health care area will have institutional complications and there will be a resilient incentives need. P4P will be integrated with harmonizing quality enhancements and involvement of cost restraint. Attention on norms of professionals in the medical field, and include providers and patients. There will be measures of performance, financial incentives will be balances with both negative and positive ones, and programs that are mandatory will be looked into to be implemented to make sure of substantial improvements in both quality and costs (Cromwell, Trisolini, Pope, Mitchell and Greenwald, 2011). P4P programs will be considered to have larger impacts of achievement in the health care field. Pay-for-performance is used to the improvement of quality of care and to reduce costs of treatments and procedures. The objective of using initiatives is to encourage providers to encounter quality values and to decrease costs. This ties reimbursement to performance and providers could be motivated to perform and deliver better care on basis that are more dependable. This should decrease the costs of health care. The ObamaCare is new and the country is going through a radical change, but pay-for-performance is becoming popular in agencies such as Medicare, Medicaid, and private insurances. But physicians and other providers using incentives for performances is raising many questions. There should be considerable monitoring and assessment to recognize planned components that completely affects results. If pay-for-performance is used effectively, it could take away some of the familiar distortions that are produced by the arrangement of the way payments are done now, and offer progressed health care delivery on dire characteristics of residents’ health. Maybe the physicians and other providers would not be concerned about the measures of quality and the reimbursements that have to be modified.